关键词: 肝硬化, Ⅱ型肝肾综合征, 特利加压素, 血管紧张素Ⅱ, 中性粒细胞明胶酶相关脂质运载蛋白, 肾损伤因子-1, 治疗

Abstract: Objective The aim of this study was to observe the efficacy of terlipressin in combination with albumin infusion for patients with cirrhosis complicated by type Ⅱ hepatorenal syndrome (HRS). Methods 60 patients with liver cirrhosis and type Ⅱ HRS were admitted to our hospital between July 2017 and May 2019, and were randomly divided into two groups, with 30 in each group. The patients in the control group were treated with intravenous albumin infusion, and those in the observation group were treated with intravenous terlipressin infusion at the basis of treatment in the control group for two weeks. Serum angiotensin Ⅱ (Ang Ⅱ), urine neutrophils enzyme related lipid carrier protein gelatin (uNGAL), and urine kidney damage factor 1 (uKIM-1) were detected. Results At the end of two week treatment, the total effective rate in the observation group was 85.3%, significantly higher than that in the control group (63.3%, P<0.05); the 24 h urine volume in the observation group was (1256.7±530.5) mL, significantly higher than that in the control group [(824.9±384.4) mL, P<0.05], the body mass was (51.8±4.5) kg, significantly lower than in the control group [(57.6±4.8) kg, P<0.05], and the abdominal circumference was (88.2±5.8) cm, significantly lower than in the control group [(95.7±6.4) cm, P<0.05]; the urea nitrogen level in the observation group was (10.8±2.4) mmol/L, significantly lower than that in the control group [(14.7±3.2) mmol/L, P<0.05], the creatinine level was (139.7±14.4) mol/L, significantly lower than in the control group [(154.9±17.5) mol/L, P<0.05], and serum sodium level was (135.8±8.2) mmol/L, significantly higher than in the control group [(132.2±7.9) mmol/L, P<0.05]; serum Ang Ⅱ level was (14.6±1.5) pg/mL, significantly lower than in the control group [ (18.3±1.8) pg/mL, P<0.05], the uNGAL level was (1.0±0.4) g/L, significantly lower than in the control group [(1.2±0.2) g/L, P<0.05], and the level of ukim-1 was (3.8±0.4) g/L, significantly lower than that in the control group [(4.4±0.3) g/L, P<0.05]. Conclusion The combination of intravenous administration of terlipressin and albumin could significantly improve the glomerular filtration functions, increase urine volume, which might be related to the reduction of serum Ang Ⅱ, uNGAL, and uKIM-1 levels.

Key words: Liver cirrhosis, Type Ⅱ hepatorenal syndrome, Terlipressin, Albumin, Angiotensin Ⅱ, Neutrophils gelatinase-associated lipid delivery protein, Renal injury factor-1, Therapy